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tv   Dr. Gary Gilliland and Dr. David Maloney Discuss Immunotherapy  CSPAN  November 1, 2016 10:00am-11:01am EDT

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you decide your own news you to i will point, and our program. what got you involve third opposed to as previous years? i think we lost steve. last caller in today's "washington journal." do it for us, we'll send our viewers now to the where an ress club, event is going on talking about cancer erapy and research event. we'll talk about the latest body's and using the own immune system to treat cancer, that will get started in we'll seeute here and you back here tomorrow morning four a.m..m. eastern, pacific. >> good morning and welcome to the national press club, where news has happened and will happen for over 108 years.
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i am the moderator of the newsmakers press conference. immunotherapy is a treatment that empowers the human immune system to overcome cancer and other debilitating diseases. over the last few years, researchers have the dutch have discovered the human immune system has a remarkable ability to locate and attack invaders like the common cold. isever, the immune system not always able to eliminate cancer cells when they form. once malignant tumors develop, they can use evasion tactics to outwit the immune system. because immunotherapies harness the patient's own immune system, they produce side effects common to traditional cancer treatments. thanks to evolving research at the fred hutchinson center in seattle, founded by brothers in 1975 -- dr. bill hutchison and his brother fred, a baseball pitcher who died of lung cancer at age 45 -- scientists have discovered new ways to tap into
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the immune system's disease-fighting power and give it the upper hand against cancer. the most significant immunotherapy breakthroughs have .appened at fred hutch fred hutch researchers were the first to show t cells can be extracted from patients and infused back into patients. researchers at fred hutch also were the first to show that t cell infusion can help shrink tumors. in june for the first time, america talked about ending cancer in a cancer men shot summit and hundreds of simultaneous gatherings in all 50 states. the afternoon long forum convened scientists from fred hutch and its partners to discuss how combined research can save more lives and reduce more suffering. for event was the largest vice president joe biden's cancer moonshot initiative, with
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a research infusion in collaboration. biden announced new cancer research partnerships, including actions to make clinical trials more accessible to patients, bring together hundreds of researchers, computer scientists, and engineers to apply supercomputing capabilities to analyze data models and cancer, and cancer surveillance data across the national laboratories, and data commons.mic the goal is to double the rate of progress toward a cure, to make advances in diagnosis, prevention, treatment, and care within five years. working onwo doctors the frontlines who have an important announcement about the promise of immunotherapy in curing cancer. gilliland is a next for imprecision medicine. dr. gilleland spent 20 years on the faculty of harvard, where he
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is professor of medicine and of stem cell and regenerative biology. his initial work focused on the genetic basis of blood cancers. theas called fred hutch epicenter for immunotherapy, because that is where bone marrow transportation provided the first reproducible evidence of the idea that the immune system can fight cancer. dr. david maloney is an immunotherapy researcher and oncologist at fred hutch who is an expert in lymphoma and my .ist, -- and myeloma he is evaluating t cells with a tumor-seeking molecule that represents a novel approach to immunity. he focuses on stem cell transplantation. a few procedural notes before i turn the floor over to dr. gilleland. please revert to turn your cell phone to mute or turn off other noisemaking devices. once our second speaker has completed his remarks, i will open the floor to questions. priority will go to media and national press club members.
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please identify yourself by name and organization. dr. gilliland? thank you very much, david, for that fantastic introduction. i think you covered most of my talking points. but i am gary gilleland, the president and director of the fred hutch -- my colleague, dr. david maloney and i, are delighted to be at the national press club for an important announcement. and i will start with what david alluded to, which is that the fred hutch has been in existence for about 41 years. it is a place where bone marrow transportation was invented by dr. don thomas. dr. thomas went on to win the nobel prize for that work, in which patients with lethal forms of cancer -- leukemia -- are treated with chemotherapy and
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radiation therapy, such high doses that they would die from that treatment, meant to eradicate their leukemia, were they not to have donor bone marrow infused to rescue them from the effects of the chemotherapy. what we did not appreciate at the time but gained an understanding of is that it was the donor's immune system that was so critical in the curative potential for bone marrow transportation. -- transplantation. we did not understand how that worked at the time. this was decades ago. over the years, we and others have a deep and broad understanding of how our immune system works around the mechanisms that activate and immune system or turn it off. tumors have a way of turning the immune system down. and by understanding those mechanisms, we can develop novel thatpeutic approaches harness the extraordinary power for our immune system to fight cancer. insights,art on those dr. maloney and his colleagues stan riddell and philip
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greenberg have developed approaches for treating cancer where we remove him in cells, t cells, from a person's body that has cancer. they are than genetically reprogrammed using very sophisticated technologies, to seek and destroy cancer cells. they are expanded. they are given back to patients as a single dose. one dose of a medicine. the dose of t cells that we give is about the size of a grain of rice. it is a very small dose. and for patients who have acute mental plastic leukemia -- mental plastic -- you have acute leukemia that has not responded to bone marrow transportation, who have the worst of the worst diseases, who have weeks or months to live, will be injected with these t cells. in 90% of cases, we see complete responses that are durable. that is another way of saying, from a clinical perspective,
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these individuals may be cured of their disease. they have complete responses any. he cannot detect when you see that kind of result, it is not like i -- like anything i have ever seen in the many years and decades i have been working in the field of cancer research and treatment. unique to act on it. you need to move with it. potential i.rative to facilitate this effort, we have recently completed the building of a new immunotherapy clinic at the hutch. brand-new construction. there will be a formal opening on december 12 of this year, with a scientific symposium i would invite all of you to attend. this will be named the besos family immunotherapy clinic. this is in recognition of the extraordinary contributions the besos family has made to this effort. in 2009, when immunotherapy was hardly a household word, the
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besos believed investigators at the hatch to thought they could reengineer t cells. at the time, that was thought to be impossible. but they believed in us. and as you know, the family is not averse to risk. they are not averse to failure. and through their support, we have enjoyed extraordinary success in reading these new treatments forward into patients with certain kinds of blood-borne cancers, like acute lymphoblastic premium. -- leukemia. you will hear more from my colleague, dr. maloney, the medical director of the unit. it is the first of its kind, state of the art, 15 bed unit that is patient centric. we bring everything to the patient, including new therapies that require intensive much as withea stem cell transportation in the early days, we are sure this will propagate across the country, as our bone marrow transplant programs did. we are very excited to be on the
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leading edge of innovation of this space, to be able to treat patients with these new immunotherapeutic approaches. and we are grateful to the bezos family for believing in us. they do not provide resources to name something. they are providing resources to shine a spotlight on the , and on on the patient the investigators. we are delighted to be able to work together with them toward developing curative approaches to cancer. so what about that "cure" word. it is a bold and provocative statement to say that we are on the cusp -- we are on an inflection point where we can anticipate seeing more and more curative therapies for cancer involved. we are curing people already. that is not the point. we know how to cure certain types of cancer. we have new approaches based on these immunotherapies. our challenge is to execute in
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the space. we need to expand the treatments so that every patient responds. 90% of patients respond with acute lymphoblastic leukemia. 10% don't. why don't those 10% respond? how durable are the responses? how do we mitigate the side effects that come from unleashing this maelstrom of immune power to destroy what amounts to pounds and pounds of tumor cells in some patients? there is a lot we need to learn. how do we expand this into all types of solid tumors, in addition to human malignancies? those are the challenges we are working on. those are tractable. those are things we believe we can achieve. we have put a stake in the ground and said, if we do not develop curative approaches to all cancers within the next 10 years, shame on us. we do have the capacity to move this field forward rapidly. that is what this immunotherapy unit is going to help us do. the other challenge we face, of course, is, how do we enable
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these technologies to move forward? the immunotherapy unit is one small part of that. david alluded to the men shot effort which we participated in actively. we just met with vice president biden' staff yesterday. we have been actively involved in the process. is a fantastic mechanism for enhancing and supporting collaboration between the various cancer centers here in the united states and worldwide. we are glad for the opportunity the moon shot brings. there are also other enablers that the moon shot has highlighted, such as, how do we ensure that all patients have access to these treatments, if they cannot come to seattle? we need to make sure there is access. we need to make sure these are tractable from a health care and cost-effectiveness perspective. these can be expensive
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treatments. are they worth the value? if you are curing people, yes, those are cost-effective. we need to solve for those challenges in a context where oncology costs are rapidly's spiraling upward. -- rapidly spiraling upward. we are very grateful to the fda for their support rapid development to these new treatments, where you can move goods forward through a mechanism be developed called breakthrough status, which means a drug that really has a dramatic effect. they have helped facilitate the development of these drugs. i had that experience when i was the senior vice president for global oncology at merck, with a drug that was another immunotherapy, the one that was used to treat president jimmy carter. and that drug was approved based on a randomized phase three trial, but on a phase one
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expansion study, the cause fda was supportive. we also are excited about dr. rick kessler's leadership in bringing together the device unit at the fda that is responsible for developing biomarker tests and diagnostics, as well as drug development. are putting those together under one oversight responsibility. that is another fantastic enabler. we also need resources to support the development of these new treatments. something wet is are ineffective -- are effective at competing with. we are grateful to senator cantwell merry and others who have -- senator cantwell murray and others who supported the benefit. we also rely on philanthropy and business development. i will complete my comments there and test the talk to my colleague, david maloney, to tell you more about the workings of the immunotherapy unit. david? thanks, gary.
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it is my pleasure to be here and be named the medical director of the basis family immunotherapy -- the bezos family immunotherapy clinic. this is a unique effort we have undertaken in seattle. based on what we have seen with immunotherapy, there are many things encompassed in immunotherapy. the focus we are having here is really on cellular immunotherapy. there are three basic types of approaches we are going to be conducted in the clinic. the first received the most press recently, and that is the gene modified -- the chimeric antigen receptive t cells. which we procedure in take normal t cells from a patient with cancer, insert a receptor, modify the gene so the film is a receptor so that it can attach to a target that is on the tumor cell.
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these cells can then be grown outside of the patient's body and given back, and will then track and attack the cancer. unlike any other cancer therapy, this is a living therapy. as the doctor said, we can give almost menu numbers of cells which then multiply in the body and track and seek out and destroy the cancer cells. they will go wherever the cancer cells can go. this form of therapy has yielded unprecedented responses, as you heard. over 90% of patients with even end-stage leukemia can go back into remission early on after this treatment. there is still a lot to be done. we are seeing a phenomenal signal about the power of the cells,system, of these t and their ability to get rid of large volumes of tumor, especially leukemia. it's very impressive.
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we also see results, not quite as good, but encouraging, in other diseases including non-hodgkin's lymphoma and chronic leukemia. the key of both the clinic and further development of these technologies is to figure out why they work so well in some cases, and why they don't work. we have seen relapses in some patients. we need to understand that. another form of therapy is called tumor-infiltrating lymphocytes. you can collect them for sites that are trying to infect the tumor, expands them in the laboratory, and give them back. a third would be t cell receptor modified t cells. that is another approach we are seeing some activity now in another form of leukemia called aml. center unique about our is that we believe the types of modify tou use to
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protect the cancer is critically important. we actually will select a type called a -- t cell helper t cell and a type called a killer t cell, modify each of them, and give them back to attack the cancer. in laboratory studies, we have found equal mixtures is way better than giving just random mixtures which you would get if you were randomly selecting the patient population. why is that important? it is important because it is the first time we have been able to identify a dose and response relationship as well as a dose and toxicity relationship. what does that mean? that means we can tailor the dose of t cells to try to avoid the toxicity, but yet maintain the efficacy. that is one of the examples of how the approach is different in our series. the clinic will enable us to
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translate research from the physician scientist to the clinic in a more rapid pace. so it is important that we can treat more patients, and it is important we can get critical trials on board. right now, the focus and all the buzz has been on the hematologic malignancies, leukemias and lymphomas, that those are not the more common types of cancers, breast cancers and lung cancers. we are beginning to develop our t cells in the clinic now in those diseases as well. and the future is extremely bright that we will hopefully be able to translate the encouraging results we are seeing in leukemia and lymphoma into these more common solid cancers. again, the purpose of the clinic is to be able to translate these early phase clinical trials from the research labs into patient clinical trials, obtain samples from the patient's -- blood tests, tumor samples -- analyze
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them in the laboratory, and make advances and go back and forth. because we are making our own car t cells, we have the ability to modify those procedures and come up with advances. what does this mean for patients? i think this means we will be able to treat more patients in a clinic and have more clinical trials open. personally for me, i have been involved in many cancer therapies over the years. i was involved in the development of an antibody against lymphoma which has changed the history of how we treat lymphomas. to see patients with literally pounds of tumors have this melt away and go into remission is extremely gratifying. but we have a long ways to go. we need to learn. we need to learn why it works in some patients. we need to learn why it does not work in some patients, why the cancer can come back in some
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cases, and be able to make this more generally deliverable to patients. that is the purpose of the center. we are starting off small. we are starting out as one center, but that is the way bone marrow transplant started, and now it is available in most countries throughout the world, thanks to dr. thomas's leadership. i think i will stop there. and i will take questions. >> we are going to take questions from the press first, and then anybody else who has any information. i will pass a microphone for you. >> i am alan potok, with science and enterprise. company fromoff your medical center, juneau
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therapeutics, has licensed the car t technology and has been conducting some of the clinical trials. licensingother activities planned? up thel this help speed development process? well, thank you. that is a terrific question. commercialization of these novel medicines is one of the most important aspects of what we are trying to do, because, to the point i made earlier, that is how we are going to get this out to the general population. we are delighted to be able to like juneauartners
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that are expert in commercialization in a way i can tell you, having industry experience, is something we are not capable of in the academic environment. we are licensing technologies to enable access to patients. patients are at the top of the list for us. the companies we do partner with an license to our capable of executing in that space. i do not know if you have anything to add to that, and david. are there any other licensees in the works? -- >> are there any other licensees in the works, or only one? many have spun off companies, so we have many licensees and a terrific vice president for business development, mickey robinson.
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we are very actively engaged in that space. laura: i am with the associated press. why does this start with the blood cancers? is there something unique that the t cells work better with those that will prove to be a larger challenge for the solid tumors? >> i will take a crack at that one. that is a great question. i think it started basically because that is where we had antibodies that were the most effective. if you go back through the development of immunotherapy in the 1980's and 1990's, we developed the concept of modified antibodies, and that took a long time to take off. it took off because the targets on the leukemias and length on this are very well-defined. we can develop antibodies against many of those targets. is thecar t cell is
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recognition part of the car, that receptor. it is a portion of the antibody that can bind to the target. it is natural that the car t cells will then follow the trail of what antibodies have been developed, at least. that has been predominantly in the hematologic malignancies. there has been an access phenomenon, meaning that in leukemias and lymphomas, which are in the blood and the bone marrow, that the t cells can very quickly get to the tumor because if they are infected -- injected intravenously, they can get to the tumor quickly, which is not the case with a solid tumor. there are likely challenges ahead to translate this into solid cancers, because we have to worry more about the microenvironment of the cancers and whether the t cells would be able to get there and be able to do their duty. it is a good question.
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>> sarah choco, with "the hill." the breakthrough/brother other things you need from the agency, from the fda, to keep this immunotherapy development going? as i said, i think the fda has been quite proactive of late drugs,oving oncology using breakthrough status. a number have been approved in a fairly short order. it is in fact light speed compared to the typical time from enrollment of the first patient into registration path for the drugs. as one example, the median is about 8.5 years in the industry from hearst in humans to fda registration. keep in mind that about 90% of drugs that go first in human fail to register. it is only a small fraction that get through.
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the fda has chosen those that are designated with breakthrough status as having a high degree of efficacy. registration is much more rapid, and that has an incredibly important impact for patients who are waiting to get access to these medicines. i think, as i mentioned, that because we now know we can stratify oncology patients for response to drugs -- you need to have a biomarker test or diagnostic test. i think having that development process synchronized with the development of the drug, under the leadership of dr. pastor, is going to add further value. from my perspective, they are doing a terrific job. reporter: there is another formological, oncological of cancer that i am familiar with, that i have not heard
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mentioned. i am wondering if it is included or applicable to the subject area we are covering. that is multiple myeloma. >> that is a great question. we are actively developing clinical trials in multiple myeloma, including development of car t cells that will be active in this arena. there are already some clinical trials that have been done at the nci and other centers that are beginning to show some activity in that regard. a matter of identifying again those target molecules on the tumor cell that you want not to be on any other tissues, so that when the car t cells, or the t cell attacks the tumor, it does not cause too much collateral damage, is the best way to think about it. we are actively working on targets and hope to have a program open in the next six
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months or so, testing car t cells in that malignancy. carole james, an independent. looking at how you look to grow the model, how will you extend collective,ium, cooperative -- whatever -- to other academic centers of immunology across the country? >> first of all, every centers trying to get into the immunotherapy space, whether it is antibodies or checkpoint inhibitors. everyone is developing programs. i think what it will require is that these products are commercialized. there are several companies now trying to commercialize car-t
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cells for leukemia and lymphoma. once those are commercialized, then centers of excellence or centers that have the monitoring capacity to treat and monitor patients receiving those will spring up the country. >> is it predominantly competitive rather than collaborative? completeey: it is not competitive. it is definitely collaborative. we are learning from all of the clinical trials. involved areups comparing notes. and trying to figure out which process is the most effective and active. those are very important questions. i think we will not be successful unless we are highly collaborative. we need to interact across centers. that is one of the greatest
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attributes of the moonshot, that there is an emphasis in making sure we collaborate. i do not think it is lack of attention that we have any complicated method sets and how we'll think about working together. the main point is our competition is cancer. not other medical centers. >> my name is jerry. i am a founding editor of the federal circuit journal and i am a patent attorney in town for the last 30 years. retired from government in 1986 before theng appellate courts in washington and helping the solicitor general argue the case in this u.s. supreme court. i was called the birth of biotechnology by some.
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a venom in 1980. are as i think both of you are referring to your collaborations with other organizations of which you are a nccn.comprising the national cancer center network, i believe is the abbreviation for. it may come close. so instant collaboration and telecommunication of knowledge back and forth, from the various clinical trials that each of them is now being involved with. there is about 26 centers. you are one in seattle. but there are others. memorial sloan-kettering in d anderson. kindle up here in baltimore. massachusetts general. all over the place.
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and you will communicate with a lot of fellow scientists in the future. >> i recognize your point. we are do have ongoing collaborations. designated cancer centers are highly collaborative and interactive. it is part of the mandate of the support from the national. so point well taken. lauren year guard with ap again. can you tell us where the hills stand? therapy hasow, to shown remarkable effect in some cancers. are not quite as potent in general as car t cells, at least logical malignancies, but we are excited in moving
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that forward. they were, as you know, developed largely at the nci. we have seen dramatic impact in some of these cancers. >> so there is not really a new focus? oryza still melanoma? dr. maloney: we are continuing those -- to deal with those diseases. that the til's are actually attacking. affecting --es trying to attack the cancer. if we can figure out the targets, we can modify cells to specifically attack that cancer. >> i had a question for you as well. if there was a silver cloud to the scourge of this epidemic, it is that there is more research on t cells. how does that affect what you are working on now?
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thank you.nd: good question. our understanding has come from a variety of sectors, including the incredible work being done in hiv-infected patients. it has led to some fantastic new therapies for hiv. we have a coordinating center for the worldwide hiv vaccine trials network, where we are trying to develop a preventive vaccine for hiv. there is a lot of crosstalk that fertilizes our approach to the diseases. but the point i would like to make emphatically is that a very significant portion of cancers humans.ed by viruses in about 25% of cancers in the united states. that includes cervical cancer, caused ice human papilloma virus, human neck viruses,
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caused by human papilloma virus. the opportunity, when he realized that cancer is dependent on the virus for propagation is you can use the to treatniques we use infectious disease. so we can vaccinate. it has the potential to eradicate cervical cancer worldwide. we just have to get the camp -- the vaccine outs. it protects against 90% of cervical cancers. if we can vaccinate girls and boys, we can prevent the developing of cervical cancer. that is a lesson learned from about othere diseases. and part of our understanding that we have responsibly to the national community, in uganda, we build a building their in collaboration with the uganda cancer institute.
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60% of cancers in sub-saharan africa are caused i viruses. we believe there is a tremendous opportunity to intervene with preventive approaches. and some of these immunotherapy the approaches are triggered and activated by viruses. it gives us the opportunity for therapeutic intervention as well. >> i was on a cruise this summer and met a pair of geneticists who, i think, were affiliated with the university of california-san francisco, probably in their fresno shop. i will use their first names -- bjorn and cindy. bjorn travels to africa extensively to work with hiv patients. i suspect some of the work you is nowscribed is work he
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doing. i do not know that, but trying hiv orlop vaccines for for any cancers caused by an hiv virus -- i do not know if that is. >> hiv does contribute to the development of cancers, hepasee sarcoma. but hiv-infected individuals are no longer dying from certain convocations. but this is a worldwide effort. we are excited to be part of that. there is a direct interface between treating viral diseases and treating cancer. anyone else?
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>> i have a load of questions. [laughter] >> we can talk with the conference, if you like. well i think a lot of times we have heard that cancer will be eradicated in our lifetime. i think you gentlemen are closer to that than we have ever calm -- come. can you comment on what we can expect the next five or 10 years? dr. gilliland: we are putting the burden on our shoulders and expect spectacular progress the next five or 10 years. i respect the vice president's goals and moving progress forward in five years. we are targeting cures for cancer. in the foreseeable future. -- i would say that we do not want to overpromise and
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under-deliver. but compared to other promises made in the past, and the vice president has made this comment in his speeches, that when mixing declared war on cancer, he had good intent. paucity of a knowledge about the underpinnings of cancer. as vice president biden said, he did not have an army. for that war. we do not have an army. nownow where we need -- we have an army. we know where we need to go and understand the mechanisms. again, i do not want to overpromise and under deliver, but we need to put the stake in the ground and say this is the time we need to move forward. >> anyone else? a question appear. -- up here. am -- i was reading your literature about the women's health
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initiative and the successes you have had in dealing with breast cancers. i wonder if you can comment on the work you are doing there. leverage what you are trying to do with immunotherapy to bring down the instances of breast cancer. dr. gilliland: thank you to the women's health initiative is a fantastic study. another example of how we are focusing not just on how do we treat cancer but how do we prevent cancer. --is much better to present prevent cancer than it is to treat it to the human papilloma virus is an extending -- outstanding example of that. a study by the government involved 160,000 women who have been followed more than a decade now. remarkableto a understandings about women's health at large and how we can affect cancer. the study demonstrated that we were using too high a dose of estrogen in some somatic postmenopausal women, increasing
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the risk of breast cancer. that had an enormous impact on the patient's lives but also on the cost of health care and productivity. families. all of the personal things that go with breast cancer diagnoses. it has been estimated that though that study cost upwards of $200 million that, in terms of lives saved, that there has been a $37 billion savings in the cost to our health care system. so it emphasizes the them -- of prevention.ce of that if we can prevent this from ever happening, that is always the most cost-effective approach. we also have active smoking cessation programs. that could have an enormous impact on the incidence ease of cancer. we are focused on both ends of that. we're looking at early detention -- early detection methods. we hope to come to a time where
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becauset need these they do not happen, but we are planning for these on both ends. >> real quick in the back. thank you. speaking of androgen -- estrogen compounds, are they still allowed in the foods we eat, ilk -- a long other farm animals. i know they had been pretty -- they have been pretty bad years ago. i know there were some good numbers about breast cancer and prostate cancer. i am doors, president of the editorial associates. dr. gilliland: thank you. i must tell you i am not an expert in that arena. i would not be able to provide a definitive answer, but i can find out. we will certainly try to look out for that.
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>> ok. a little more -- if there are no questions, we conclude this. we look forward to more developments. thank you. [applause] [captions copyright national cable satellite corp. 2016] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit] >> will this be available? >> it was on live tv, so you can go back and rewatch it.
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>> you can find this conversation online. video library.he more live coverage of events later today at noon eastern time. looking at gun violence and how to respond with legislation. that conversation held on capitol hill, hosted either university of california irvine: e school of law. and we will be with the nominees in battleground states. donald trump will be in eau cl aire, wisconsin. that is tonight at 8:00 on c-span. on c-span 2, hillary holds a campaign rally in fort lauderdale, florida at a data -- at 8:45. house speaker paul ryan said he cast his ballot last week for early voting.n
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he endorsed donald trump wouldn't it campaign for him. , one'senator ted cruz donald trump's opponent, says he voted for the republican nominee. he told a houston tv station he voted a straight republican ticket. and senator marco rubio suggested to reporters he also voted for donald trump. if "miami herald" asked him -- who he had voted for, and he replied that nothing had changed. >> on election day, the nation decides he will be the next resident and who controls the house and senate. stay with c-span for election coverage, including campaign stops with hillary clinton and donald trump and their surrogates, and follow our coverage of the senate and house debates and speeches. c-span -- where history unfolds daily. >> the u.s. candidates of the house for minnesota's third
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congressional district held a debate release in late. incumbent republican erik paulsen faced his democratic challenger terri bonoff. discussed tax policy, the affordable, donald trump, and national security. the debate is about half an hour. minnesota's third congressional district covers the west metro. here, you find cities like to rabbits and maple groves. a friday of industries call this place home, including several medical technology companies. republican erik paulsen was elected in 2008 after serving as house majority leader state legislature. this year, he faces democratic challenger terri bonoff, who served in them minnesota senate. now we have representative eric paulsen and state senator terri bonoff from the third district. thank you for coming in for this
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debate, which we really have more of a conversation here. thank you for coming in. senator bonoff, let's start with you. state sen. bonoff: i am running for congress because i believe in the promise of our country and its people. it is more important now than ever before that we elect courageous leaders who can bring people together on both sides of the aisle to tackle our real tough challenges. in the minnesota senate, i have earned a reputation for doing that. as a pro-business democrat, i work with the minnesota changer to create the minnesota pipeline project area that was about getting rid of student debt and addressing the skills gap. it connected students with employers. they got on the job training, get paid wages while getting their degree. while they are done, they have a job. that work has been written about twice in the last year by "forbes" magazine. it is that kind of bold leadership i will bring to
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congress, where it is lacking. congressman paulsen, you have been there three -- you have been there eight years and i think you have country beaded to that gridlock. i also believe you have voted to often on the wrong side of history, with the extreme part of the right wing part of your party. so i believe i have the values and vision to represent this district. i was proud to be endorsed by it community the newspapers. what they said was that i represented real hope and change. so i have been a courageous leader in the business world, in the minnesota senate, and i would read out in washington. >> thank you. representative paulsen? rep. paulsen: thank you thank you for hosting the debate with kstp. now is the time where minnesota
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expects elected leaders to work across the aisle bipartisanly. i have a great track record of doing that. i will continue to do that. whether repealing the medical device tax, which focuses on keeping high paying jobs in the state, high paying jobs that are so critical in all of minnesota. i worked on that with senator clover shar-pei and it took five years to get that across the finish line. so sometimes i can take a wild. -- a while. or something like stopping human trafficking -- we have been able to do that in less in a year. recently, i passed the missing children bill which will help find missing children and put sexy offenders behind bars. we are in a time with partisan gridlock and politics. i want to continue to be part of a constructive solution. it is one of the reasons i was endorsed by the "minnesota star
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tribune" recently and with business associations like twin chambers. i will continue to work in that mold. i am one of 44 members this year that had a bill signed by the president from either party in either body. that is what minnesota rep -- expects. i will continue to do that if i am reelected. >> let's focus on the economy. ae third district is home to mix of industries pay there are large corporations, small businesses, technology startups. what needs to be done to make sure that the third district specifically continues to create jobs and continues to be economically viable? rep. paulsen: there is no doubt our economy should be performing better than it is now. it is the worst economic recovery in the history of the country. we have record numbers of people working part-time that want to work full-time. we are in both cap now. we have one third of folks aged 18 to 31 living at home with
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their parents. the biggest percentage in 40 years. and it is the first time during an economic recovery where we have literally had median income of fall. we need tax reform. we needed to help international operations do more competitiveness, bring jobs back on, yet earnings back home, keep headquarters here. it also means we need to help small businesses, which means lowering their business tax rates. terri has voted for a fourth tier income tax. that hits small business hard. so we have a different view on fiscal issues. but tax reform is absolutely needed to help create more jobs in the local economy. state sen. bonoff: there is nothing more important, as i look at what the job of being a congress one would be, then making sure we have a strong economy and grow jobs.
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on asota has an impressive plumbing right now. 3.7%. but there are those who have timed out after the recession and never got back into the job force. so we have to do all we can to ensure a strong economy. one of the first -- most important things we can do is look at the next generation. that is why i shared about my work with regards to the pipeline project. but small business is the engine of our economy. in the senate, that is what i focused on. i was the chief author of the angel investments start up tax credit. and also the r&d investment credit. and i worked with jennifer luna, a republican from your community in the house, to do equity crowdfunding. accredited investors to be able to invest online, so startups have more access to capital. but i believe we need to do
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significant tax reforms. we are blessed to have fortune 500 companies in our midst. we need to reform our tax code so they can bring their process back. i have toomment -- address this about the fourth tier. the only tax i have voted for was in regard to income taxes. it was back in 2009 when we had a constitutional obligation to balance the budget. it never happened. the governor proposed a fourth that became law. i was one of the few democrats that voted against that. because of that and several other votes i have taken, i have been endorsed in every reelection by the minnesota chamber, the twin west chamber. i have gotten the guardian a small business award each of my last reelections, including this past summer. i do not believe the answer is to increase the tax burden. and the "star tribune" actually did say that you are said that
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congressman paulsen mischaracterize my record and i have a record of fiscal restraint. rep. paulsen: just to be clear, you did vote for a fourth tier income tax, a billion-dollar tax increase that would hit small businesses. a time when small businesses cannot afford to pay more. and every one of those business organizations have now endorsed my candidacy, because they understand the difference. i will continue to work across the aisle on bipartisan issues. state sen. bonoff: you'd purposely distort my record and bought a domain name called "taxing terri" which seems uncharacteristically of a congressman but kind of takes a page out of the playbook of donald trump, where you call people names. what i would say is i want everyone to know i did not vote or the recent tax increase. that when we were faced with a difficult choice -- how will we close the budget gap, and we have a constitutional obligation
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to balance the budget, we had a choice. are from schools or raise taxes? we ended up arming from schools. i did not vote to raise taxes. and i issued a bill or worked on a bill to exempt small businesses from that fourth year rate. i think it is a burden on small businesses. i think we have to take the burden away from small businesses. leah: let's talk about the medical device tax. congressman paulson, i know you have in supportive of suspending the medical device tax. what do youbonoff, think about the future of that? state sen. bonoff: i support a permanent repeal. it is very important to our communities that that happens. i appreciate it. leadership paulsen's on that. but the bigger question is what is the future of the affordable and how will we pay for it?
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so i welcome getting into that discussion. leah: and what about you, representative? would you support a full repeal of the tax? rep. paulsen: absolutely. it took five years to get across the finish line. the only reason we were able to get across the finish line is because of the bipartisan work and leadership i was able to do in the house. the entire minnesota delegation was on board. baduse this was such a policy, herding patience and jobs in minnesota, we ended up with a you-proof margin, despite to president's objections, get this across the finish line. now, we are seeing money back and research and development, it will help our patients and jobs. let's dig into this more.
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seen the cost of health insurance going up some six or 7%. the governor says affordable care act is not affordable anymore. representative paulsen, you voted to repeal the aca. what is the solution then? getting rid of the whole thing, making changes? rep. paulsen: we will have to start over. number one, you have a system now that has no competition. some states offer only one provider or carrier. so of course they will have skyrocketing insurance states. counties in some minnesota not even able to offer insurance, which would be a disaster. this is a real crisis issue. you have to have insurance companies able to buy and sell across state lines, you need health insurance to be portable, so you take it with you. rely on yourve to employer, you should be able to take it with you like a backpack in life and take it with you
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throughout your life. and more chronic care management is the direction to go. terri voted for bringing obamacare to minnesota. it is a disaster. it is hurting minnesota families. i have never voted for obama care. we need to move forward. leah: explain where you stand. state sen. bonoff: erik has run tv commercials that said i voted for obama care. that is kind of silly, because obamacare was done in congress. i am not in congress. so i did not vote for obama care. so when the federal government mandated the states have the thege and democrats had reformed part, i voted no. the reason i did that is because i have a great relationship with the company's in my district, the health industry companies.


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